Primary Hematopoietic and Lymphoid Tissue ›› Bone Marrow ›› Abnormal

Ring Sideroblast*

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Microscopic Features:
  • Size is variable depending on the stage of maturation
  • nuclear to cytoplasmic ratio is variable depending on the stage of maturartion
  • Round Nucleus
  • Nucleoli are NOT visible
  • Iron deposits are visualized with iron stain as blue granules (5 or more granules which encircles >1/3 of the nucleus)
Normal % blood-PB, marrow-BM, lymphoid tissue-LN:
  • PB: None
  • BM: None
  • LN: None
May Resemble:
  • Sideroblast is similar on iron stain but with less than 5 granules
Differential Diagnoses:

Increased in:
Zinc toxicity induced copper deficiency
MDS (e.g. Refractory Anemia with Ring Sideroblast)
States of iron overload such as hemochromatosis (sometimes)

Classic Immunophenotype:
  • CD45-
  • CD117-
  • CD235a (Glycophorin A) dim+
  • CD71+
  • Note: The immunoprofile can be variable and may show aberrancies
Cartoon Image:

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for direct comparison

  • Normally no more than 5 siderosomes (inclusions) are present per cell. Hence, ring sideoblast is an Abnormal finding.

Content Editors/Website Administrators:
Hooman H. Rashidi, MD; John C. Nguyen, MD